CAJ | 학술논문

目的应用双脉冲波多普勒超声实时同步观测正常左心室壁局部心肌组织运动及相邻位点腔内多普勒血流速度频谱,评价舒张期左心室壁节段心肌应变与相邻流场压差的时空相关关系.方法应用脉冲波多普勒/组织多普勒(PW/TDI)频谱技术对86例行常规体检的健康受试者的二尖瓣处及左心室3个标准心尖长轴切面各室壁基底段、中段、心尖段的心肌舒张早期峰值速度、舒张晚期峰值速度、舒张早期血流峰值速度进行定量观察,并分析舒张期正常左心室局部心肌应变与相邻血液流场压差的时空关系.结果 ①左心室壁各节段舒张早期和晚期心肌运动峰值速度以及相邻腔内位点舒张早期血流峰值速度由基底、中段至心尖逐步减低(P ＜0.01).②二尖瓣环舒张早期峰值速度与二尖瓣口舒张早期血流峰值速度具有相关性(r =0.418,P＜0.001).正常人各室壁节段心肌舒张早期峰值速度与相邻血流舒张早期峰值速度均存在相关关系,其中整体r =0.412,P＜0.001；后间隔r=0.610,P＜0.001.③左心室室壁部分节段心肌长轴应变与相邻血液流场压差间具有相关性,其中后间隔r=0.319,P＜0.005.结论左心室各节段心肌舒张早期峰值速度与相邻血流舒张早期峰值速度以及部分节段心肌长轴应变与血液流场压差间具有相关性,这种相关关系的建立有可能为临床早期精确评价左心室流固耦合提供一种全新的方法.
목적 응용쌍맥충파다보륵초성실시동보관측정상좌심실벽국부심기조직운동급상린위점강내다보륵혈류속도빈보,평개서장기좌심실벽절단심기응변여상린류장압차적시공상관관계.방법 응용맥충파다보륵/조직다보륵(PW/TDI)빈보기술대86례행상규체검적건강수시자적이첨판처급좌심실3개표준심첨장축절면각실벽기저단、중단、심첨단적심기서장조기봉치속도、서장만기봉치속도、서장조기혈류봉치속도진행정량관찰,병분석서장기정상좌심실국부심기응변여상린혈액류장압차적시공관계.결과 ①좌심실벽각절단서장조기화만기심기운동봉치속도이급상린강내위점서장조기혈류봉치속도유기저、중단지심첨축보감저(P ＜0.01).②이첨판배서장조기봉치속도여이첨판구서장조기혈류봉치속도구유상관성(r =0.418,P＜0.001).정상인각실벽절단심기서장조기봉치속도여상린혈류서장조기봉치속도균존재상관관계,기중정체r =0.412,P＜0.001；후간격r=0.610,P＜0.001.③좌심실실벽부분절단심기장축응변여상린혈액류장압차간구유상관성,기중후간격r=0.319,P＜0.005.결론 좌심실각절단심기서장조기봉치속도여상린혈류서장조기봉치속도이급부분절단심기장축응변여혈액류장압차간구유상관성,저충상관관계적건립유가능위림상조기정학평개좌심실류고우합제공일충전신적방법.
Objective To investigate regional ventricular long-axis velocity and adjacent intraventricular flow velocity using dual-pulse wave(PW) Doppler echocardiography synchronously,and to analyze the coupling relationship between regional ventricular long-axis strain and adjacent intraventricular pressure gradients in normal cases using dual-PW Doppler echocardiography.Methods Eighty-six normal subjects aged 19～66 years [mean age (37.49 ± 11.97)years] underwent routine echocardiography and dualPW Doppler echocardiographic exam.Total 18 segments were sampled using dual-PW Doppler (PW/TDI mode) images at basal,mid and apical levels on three standard apical views,and electrocardiogram was recorded simultaneously.Peak early diastolic velocity (emax),peak late diastolic velocity (amax),peak early mitral diastolic inflow velocity (Emax),regional peak early diastolic velocity (Em),regional peak late diastolic velocity (Am) and regional peak early diastolic inflow velocity (E) were measured simultaneously in the same one cardiac cycle.Myocardial variations of left ventricular segments were observed.Em,Am and E of different levels from different ventricular wall were analyzed.The co-relationship between regional ventricular long-axis strain and adjacent intraventricular pressure gradients were calculated and analyzed.Results ①Regional myocardial velocity and regional peak early diastolic inflow velocity in normal subjects declined from basal to apical segments gradually at the same ventricular wall (P ＜ 0.01).② Emax was correlated with emax(r =0.418,P ＜0.001),and E was correlated with Em (posterior septum,r =0.610,P ＜0.001 ；anterior wall,r =0.499,P ＜0.001).③There was a medium correlation between normal longaxis strain in segments and adjacent intraventricular pressure gradients (the global,r =0.412,P ＜0.001 ；posterior septum,r =0.319,P ＜0.005).Conclusions The acquirement of E and Em by dual-PW Doppler showed downtrend of segmental wall movement and regional blood flow from basal segment to apex.Emax is correlated with e E is correlated with Em,and long-axis strain at segments is correlated with adjacent intraventricular pressure gradients partly.Dual-PW Doppler might provide a potential method for the more precise evaluation of left ventricular fluid-solid coupling during diastole.